NPI | 1104548692 |
---|---|
Doing Business As | PREMIUM DENTAL |
Entity Type | Organization |
Authorized Contact | CHRISTOPHER JORDAN Owner/Dentist 949-654-2737 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-09-13 |
Last Update Date | 2022-12-29 |