| NPI | 1902013683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN J SPEARS Administrator 949-640-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37165) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |