| NPI | 1225221484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARTINEZ Dentist 661-831-8042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47533) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |