| NPI | 1023846920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN STEPHENS Owner 562-331-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-07-23 |