| NPI | 1245690445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN YAR Owner / President 949-310-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54397) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 54397) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2017-03-23 |