| NPI | 1841933389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RUDAT Office Manager 714-606-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-13 |