| NPI | 1790931046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA VALENZUELA Area Manager 951-340-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 53592) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |