| NPI | 1427239151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE I TALUKDAR Secretary 909-625-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 47269) |
| Enumeration Date | 2007-11-22 |
| Last Update Date | 2007-11-22 |