| NPI | 1114053824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY MAI PHAM Dentist Owner 951-687-4155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 39461) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2014-07-16 |