| NPI | 1316135122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MORANA President 951-686-7420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43372) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |