| NPI | 1609036706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA A KOGAN Dentist/Owner 909-793-5270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49427) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2008-06-11 |