NPI | 1043590060 |
---|---|
Doing Business As | BLUE CRYSTAL DENTAL |
Entity Type | Organization |
Authorized Contact | PEDRO M SANDOVAL President 909-873-9707 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 49402) |
Enumeration Date | 2011-08-22 |
Last Update Date | 2019-04-09 |