| NPI | 1043575798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OFELIA KARAAN COSTALES President/Owner 310-518-6802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 48250) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |