| NPI | 1184368953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT O NICHOLS Owner, Dentist 714-724-9072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |