| NPI | 1043228901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA A CASTELLON Vice President 818-895-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 36639) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 40210) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |