| NPI | 1770572059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THUY T FORTIER Dentist Owner Of Corporation 714-898-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41831) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 41880) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2017-04-12 |