| NPI | 1649169434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEJANDRA BERENICE DE ANDA Office Administrator 714-650-9381 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2025-06-28 |
| Last Update Date | 2025-06-28 |