| NPI | 1285775502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J GONG Chief Executive Officer 661-854-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 29891) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2014-10-03 |