| NPI | 1770666760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN LYN CHAPMAN Secretary 909-982-8924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 38647) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |