| NPI | 1598067092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIET MINH TRAN CEO 951-600-0858 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2010-12-03 |