| NPI | 1740999895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY CORPODIAN Owner 949-364-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-21 |