| NPI | 1184094310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WILLIAM ARCHUNG Treasurer 714-343-6114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47227) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 49919) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |