| NPI | 1962074997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNG YOUNG LEE President 951-736-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-27 |