| NPI | 1053064691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARIE VEN DANGE Owner 714-206-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2023-12-14 |