| NPI | 1427280742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA THERESA AMISOLA Owner 909-979-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50723) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |