| NPI | 1467775122 | 
|---|---|
| Doing Business As | NELLIE GAIL ORTHODONTICS | 
| Entity Type | Organization | 
| Authorized Contact | RICHARD LLOYD BOTZBACH Owner, President 949-362-9971  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 39235)  | 
| Enumeration Date | 2010-03-10 | 
| Last Update Date | 2010-03-10 |