| NPI | 1033667282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDELL GARY SANTOS JACINTO Dentist/Owner 323-931-1385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 36383) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |