| NPI | 1063609196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISEL GONZALEZ-DIAZ President Of Corporation 951-785-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-10 |