NPI | 1104149038 |
---|---|
Doing Business As | VICTORY DENTAL PRACTICE |
Entity Type | Organization |
Authorized Contact | MARIA VENERACION SANTOS Dentist 951-445-4407 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39078) |
Enumeration Date | 2010-03-06 |
Last Update Date | 2010-03-06 |