NPI | 1316435514 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHERINE AHN WALLACE President 714-230-2434 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 261Q00000X Clinic/Center |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2018-04-24 |
Last Update Date | 2018-04-24 |