| NPI | 1295272391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER VERGA Doctor/Owner 808-961-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2024-10-17 |