| NPI | 1255100020 |
|---|---|
| Doing Business As | MORENO BEACH DENTAL |
| Entity Type | Organization |
| Authorized Contact | MYUNG KEE PARK CEO 909-524-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2023-12-21 |