| NPI | 1801093034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNG MIN AHN CEO 760-244-4844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 52706) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-07-06 |