| NPI | 1811564909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN FORD Owner 714-842-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-01-29 |