| NPI | 1447650296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CHU CEO 760-388-5080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 51245) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 60879) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-08-29 |