NPI | 1275835407 |
---|---|
Entity Type | Organization |
Authorized Contact | RAFAELA DELARA Administrator 909-793-8793 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 48644) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 57581) |
1223G0001X Dentist, General Practice (Licence: CA 57930) | |
1223G0001X Dentist, General Practice (Licence: CA 46985) | |
1223G0001X Dentist, General Practice (Licence: CA 59318) | |
1223G0001X Dentist, General Practice (Licence: CA 58057) | |
1223G0001X Dentist, General Practice (Licence: CA 53832) | |
1223P0300X Dentist, Periodontics (Licence: CA 38226) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 24358) | |
124Q00000X Dental Hygienist (Licence: CA 25296) | |
Enumeration Date | 2010-11-19 |
Last Update Date | 2010-11-19 |