| NPI | 1225033343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J DOLAS Partner 714-572-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA D34395) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA D32296) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |