| NPI | 1922809128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN LAWRENCE MILLER Owner/President 714-878-5783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |