| NPI | 1336279702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SACHIKO VIRGINIA FUKUMAN Owner 949-248-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 28554) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |