| NPI | 1164848552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLEDAD BOND Administrator 661-298-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 39280) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 39280) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-09-08 |