| NPI | 1942437983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA O ASIL Office Manager 949-481-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 52710) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 56645) |
| 1223P0300X Dentist, Periodontics (Licence: CA 49560) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 52200) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |