| NPI | 1053652396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGALY M VELASQUEZ Owner/CEO 909-466-4999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 60169) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2015-07-28 |