| NPI | 1497979280 |
|---|---|
| Other Name | EAGLE GLEN DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SANG CHURL PAIK Owner Dentist 951-270-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 41861) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |