| NPI | 1588745459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA CANDACE FUNDERBURK Dental Consultant 714-716-6244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 21371) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-04-16 |