| NPI | 1891717591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY DAVID CLIBON President 949-633-2635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44580) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-08-22 |