| NPI | 1356844484 |
|---|---|
| Doing Business As | ANCESTRY DENTAL |
| Entity Type | Organization |
| Authorized Contact | DYLAN N DO Owner 714-333-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |