| NPI | 1912452723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR B ESPARZA President 909-613-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 305R00000X Preferred Provider Organization (Licence: CA 41648) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2022-12-08 |