| NPI | 1154525590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS ROBERTO CHONG President 760-634-7980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 42640) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2021-09-21 |