| NPI | 1487793162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MENDOZA Office Mngr 909-985-9215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: 20456) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-08-05 |