| NPI | 1992028708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA VO Office Manager 949-499-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 42310) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |