| NPI | 1609229244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANYELLE DEL PRADO Office Manager 949-363-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |