| NPI | 1578968541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA K. CHOI Owner 909-948-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 41715) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 64029) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2014-11-03 |