NPI | 1144370768 |
---|---|
Doing Business As | COASTAL DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | DEREK DUNGQUANG DUONG President 949-515-9280 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48906) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2017-12-29 |