| NPI | 1811021751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER V LE Partner 714-549-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38316) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 38293) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2016-10-12 |