| NPI | 1194913673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MATTHEW NISCO Orthodontist/Owner 714-979-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 032598) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2015-10-07 |