| NPI | 1033606991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE ELIZABETH KUSKE Dentist 562-964-0877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: CA 57535) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 57535) |
| 1223G0001X Dentist, General Practice (Licence: CA 57535) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |