NPI | 1841892148 |
---|---|
Entity Type | Organization |
Authorized Contact | CRAIG THIEDE Office Manager 714-730-6767 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-11-11 |
Last Update Date | 2023-02-24 |