| NPI | 1679932032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JINGJING LI CEO 909-869-1098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56851) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 56851) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 46308) | |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-08-01 |