| NPI | 1154468965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUY W MENDIVIL Owner 949-859-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA D29737) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-06-09 |