NPI | 1437406873 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA MIEUN PARK-LEE Owner/Partner 909-888-5499 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 40976) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 36091) |
Enumeration Date | 2012-08-03 |
Last Update Date | 2012-08-03 |