| NPI | 1437872777 |
|---|---|
| Doing Business As | SANTA MARIA PEDIATRIC DENTAL GROUP & ORTHO |
| Entity Type | Organization |
| Authorized Contact | KEITH TAM General Partner 949-322-9778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |