| NPI | 1558122275 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AURORA ALVA Owner 877-712-7875  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry | 
| Enumeration Date | 2024-01-19 | 
| Last Update Date | 2025-05-02 |