| NPI | 1932331246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN W LAKSANA President 909-949-7002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA B35512) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |