| NPI | 1720486889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA T NGUYEN General Dentist 951-277-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56619) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56885) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2014-12-05 |