| NPI | 1053510495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LEE Owner/President 661-663-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41106) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2008-04-15 |