| NPI | 1285941005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA LESLIE COSTELLO Office Administrator 714-953-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 31142) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |