| 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 |