| NPI | 1508085648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE TONG Dentist 949-859-8599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 33186) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2023-03-25 |