| NPI | 1053152025 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GREGORY WRIGHT President 760-415-7777  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | 
| Enumeration Date | 2024-06-04 | 
| Last Update Date | 2024-06-04 |