| NPI | 1659798262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE M JUSTIN President 909-886-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 51084) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-05-27 |