| NPI | 1891839072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY STEPHEN DAVIS CEO 949-554-4844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52166) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2013-07-16 |