| NPI | 1376002279 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PAUL DAWOOD Owner 714-956-0857  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery | 
| Enumeration Date | 2019-03-19 | 
| Last Update Date | 2019-03-19 |