| NPI | 1962524454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL EILEEN MCDONOUGH President 949-492-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 44939) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2010-06-01 |