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 |