| NPI | 1124185194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY DALE NEAL Vice President 909-558-4543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 2043) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-03-18 |