| NPI | 1881330710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONOLO B. ODIRIL Dentist/Owner 267-270-0068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |