| NPI | 1467945212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN ALEJANDRO MEDINA-MARTINEZ President 661-437-6877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 102012) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-03-07 |