| NPI | 1609088541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA M GAMA President 909-986-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA D48269) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2021-01-13 |