| NPI | 1689007460 |
|---|---|
| Doing Business As | VICTOR VALLEY KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRIAN CHU CEO 760-490-0790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 51245) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 51245) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |