| NPI | 1912266388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM S MARTINEZ Dentist 909-354-6211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58323) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |