| NPI | 1265962773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE HERNANDEZ-ZAMUDIO Owner/CEO 951-318-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 45873) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2017-06-16 |