| NPI | 1639476765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ALFREDO VELAZQUEZ President 909-829-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44119) |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |