| NPI | 1568139319 |
|---|---|
| Doing Business As | LOS OLIVOS DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KEVIN JING-YUAN SU Owner 949-966-2781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2021-08-27 |