| NPI | 1598171993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY NGUYEN President/Dentist 909-890-9398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 57981) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CA 57891) |
| 302R00000X Health Maintenance Organization (Licence: CA 57981) | |
| 305S00000X Point of Service (Licence: CA 57981) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |