| NPI | 1548658412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIE M SCOTT Consultant 949-632-9820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51072) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |