| NPI | 1801034723 |
|---|---|
| Former Legal Business Name | FOUNTAIN VALLEY DENTAL ESTHETICS |
| Entity Type | Organization |
| Authorized Contact | NILESH PEMA Owner 714-887-4337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |