| NPI | 1255865705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY INTON DIZON President 909-476-2821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 53059) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |