| NPI | 1750855995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LEE CEO 714-964-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2019-01-21 |