| NPI | 1689499204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLAINE ALONSAGAY-DEL CAMPO Doctor 949-418-7339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2024-11-19 |