| NPI | 1205600699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SON CAO Orthodontist 559-303-0399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |