| NPI | 1467734491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. CARPENTER Owner 951-682-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: CA RHP00050468) |
| Additional Taxonomies | 292200000X Dental Laboratory (Licence: CA RHP7971) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |