| NPI | 1568748234 |
|---|---|
| Doing Business As | TUSTIN BLUE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | WILLIAMS D SARAIVA President 714-669-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2012-03-14 |