| NPI | 1134644149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE ANN ROGERS Office Assistant 951-677-5113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 53656) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-07-21 |