| NPI | 1033399332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THU DANG Bookkeeping 818-387-6387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 44473) |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2020-03-05 |