| NPI | 1720577570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ANNETTE AVILA Dentist 951-361-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 49460) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |