| NPI | 1679147896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA MASCARO CHAMEBRLAIN-UMANOFF CEO 909-856-9748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |