| NPI | 1962791459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE LUIS GERONIMO Dentist 714-550-7172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47897) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-05 |