| NPI | 1972013928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAO Q HO Incorporator 714-879-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 100004) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2023-08-04 |