| NPI | 1023571650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA IPAPO AGUSTIN President 626-336-4453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |