| NPI | 1902999238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THANH HANG LE CEO 714-539-9539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41103) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 49014) |
| 1223G0001X Dentist, General Practice (Licence: CA 47159) | |
| 1223G0001X Dentist, General Practice (Licence: CA 52580) | |
| 1223G0001X Dentist, General Practice (Licence: CA 52471) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 44533) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 50018) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-08-22 |