NPI | 1558872879 |
---|---|
Entity Type | Organization |
Authorized Contact | TREVOR DUC LUU Owner 714-655-4405 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 55535) |
Enumeration Date | 2017-10-12 |
Last Update Date | 2018-06-27 |