| NPI | 1649534959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EFRAIM JOHN MORENO Owner 949-487-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA d29929) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |