NPI | 1982074241 |
---|---|
Entity Type | Organization |
Authorized Contact | PEACE KIM CEO 949-232-7965 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 63279) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS040224) |
Enumeration Date | 2015-09-30 |
Last Update Date | 2015-09-30 |