| NPI | 1053551085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI LANETTE HENDERSON Dentist 310-246-1068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 44890) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2009-03-04 |