| NPI | 1124469606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN GOCKE Clinic Administrator 661-942-1179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 31212) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |