NPI | 1194572198 |
---|---|
Doing Business As | EASTLAKE FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | BARBARA MARRA VP 949-545-8847 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2024-05-06 |
Last Update Date | 2024-05-06 |