| NPI | 1972826170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILIANA CUELLAR Director 909-763-2581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 50235) |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2024-01-25 |