| NPI | 1033618681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOONKI LEE Owner 213-384-1036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA DDS62164) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-09-13 |