| NPI | 1205466877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA DENOLO-CHAVEZ Owner 714-519-1892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |