| NPI | 1609392190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN TRAN Owner 951-679-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 63456) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |