| NPI | 1437324555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME NORMAN PETERSON Dentist 714-557-7744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA 23551) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |