| NPI | 1578013926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY Q TRAN CEO 951-691-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44371) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 49453) |
| 1223E0200X Dentist Endodontics (Licence: CA 55928) | |
| 1223G0001X Dentist General Practice (Licence: CA 54782) | |
| 1223G0001X Dentist General Practice (Licence: CA 58730) | |
| 1223G0001X Dentist General Practice (Licence: CA 50727) | |
| 1223P0300X Dentist Periodontics (Licence: CA 53739) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 55220) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 58059) | |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |