| NPI | 1417091430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JAEKWAN JO President 951-359-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 30682) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |