| NPI | 1437160108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY TRUONG CEO 951-898-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 46538) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 47968) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |