| NPI | 1043502784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELIN PATRICIA BARBA Manager 661-324-1725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2019-04-12 |