| NPI | 1356828693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID DIAZ Rece PT Ion 909-689-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49674) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-07-19 |