| NPI | 1043273535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUDIVINA LUIS PAGATPATAN Owner 310-303-3988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48162) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2020-08-22 |