| NPI | 1831414119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER GREGORY GLADKOV Owner 714-953-6881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 40822) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |