| NPI | 1104010396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE HUONG THAI President 949-837-8482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 36015) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2020-02-11 |