| NPI | 1215478623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY K ADDONIZIO Owner/Dentist 949-582-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 35214) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |