| NPI | 1790258556 |
|---|---|
| Doing Business As | WEST CORONA DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TUAN LY Owner/Partner 951-340-0200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2020-10-06 |