| NPI | 1881967644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE C TAN President 951-925-4002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55034) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |