| NPI | 1063164556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO PINEDA Insurance COO Rdinator 661-450-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |