| NPI | 1619592102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PREET TAKKAR Chief Information Officer 714-571-3372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-11 |