NPI | 1790054344 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY PACKER JOHNSON President 949-552-5800 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA D22813) |
Enumeration Date | 2011-12-27 |
Last Update Date | 2011-12-30 |