| NPI | 1649329699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE R. JOHNSTONE Periodontist President 714-730-7877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 22507) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |