| NPI | 1366112898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE SUN Owner 714-393-2043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |