| NPI | 1245497932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW EDWARD DUDZIAK President 909-581-7761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 73) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |