| 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 |