| NPI | 1174752331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA DIMERIN BENGO Dentist 714-999-9150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52344) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2009-07-09 |