| NPI | 1417483371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI THEERATHADA Doctor 714-839-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56371) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |