| NPI | 1780076034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA BARRAGAN Insurance Biller 951-784-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 45071) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2022-02-09 |