| NPI | 1962811349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD LEE IMAN Owner/ CEO 951-283-4626 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 30538) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |