NPI | 1508870866 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK FAGIN President 949-554-4434 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 52161) |
Enumeration Date | 2006-07-29 |
Last Update Date | 2022-07-21 |