| NPI | 1790232205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA SUSAN AHLERS Owner Dentist/President 714-602-6327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 34569) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2020-12-14 |