| NPI | 1598800864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DOUGLAS FOWLE General Partner 949-364-0590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 24777) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |