| NPI | 1043385107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN C LEWIS Business Manager 714-990-8891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 27162) |
| Additional Taxonomies | 122300000X Dentist (Licence: 27162) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-07-03 |