| NPI | 1053609842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S DEAN President 909-327-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 59436) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |