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 |