| NPI | 1114012259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GEORGE GARDINER President 909-946-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 29716) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-07-31 |