| NPI | 1629528542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO J CASTELLANOS Dentist 951-765-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 60364) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2017-02-06 |