| NPI | 1649817404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNG MIN AHN CEO 909-256-4457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-11-28 |
| Last Update Date | 2021-07-06 |