| NPI | 1356442594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH CLAUD BAKER President 909-984-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 15932) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 44289) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |