| NPI | 1629557517 |
|---|---|
| Doing Business As | PACKING HOUSE DISTRICT DENTAL & ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | HOMER KETCHERSIDE President 909-810-7167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 28872) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2020-05-11 |