| NPI | 1699380485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUYNH NHU PHAN Dentist 714-623-2107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |