| NPI | 1407733587 |
|---|---|
| Doing Business As | DIVISION STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | GLENN LAMONT HORN Director Of Operations 661-609-0235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |