| NPI | 1386031151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE MEYER Office Manager 949-640-9554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38178) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 60644) |
| 1223G0001X Dentist, General Practice (Licence: CA 63542) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |