| NPI | 1437707965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANA MARTINEZ Director Payer Contracting 714-428-1326 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |