| NPI | 1437737673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA GONZALEZ President 949-335-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-04-09 |