| 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 |