| NPI | 1659499325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER President 951-652-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 28914) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2013-07-04 |