| NPI | 1689039570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN A TREJO CANCHOLA Owner 951-842-0803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 61049) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2015-12-21 |