| NPI | 1750576096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO J VILLARROEL Owner 909-421-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 44377) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |