| NPI | 1164268439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KWON Owner 714-892-5710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-05 |