| NPI | 1508016742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA FUNDERBURK Offer Mgr 714-716-6244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |