| NPI | 1417128034 |
|---|---|
| Doing Business As | EAGLE GLEN DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | PAULINE PHAM WONG President 951-270-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 53643) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |