| NPI | 1659751899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA THERESE AMISOLA CEO 909-622-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50723) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |