| NPI | 1417471475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA ALMAZAN Billing Manager 909-944-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 55014) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |