| NPI | 1457638629 |
|---|---|
| Other Name | HUMPHRIES ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | SAGE M HUMPHRIES Owner/President 714-997-5961 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 53072) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |