| NPI | 1093800039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN P. FRIAL President/Orthodontist 949-276-2105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 41012) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-02-17 |