| NPI | 1477080901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MICHELLE NIERODE Pediatric Dentist 714-717-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-07-14 |