| NPI | 1811910987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER M KELLEN President 949-586-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA D21375) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-07-25 |