| NPI | 1376213546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO JAMES RICCIARDI Owner 909-980-6252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-09-21 |