| NPI | 1053648782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN NEWHART Vice President 310-550-1533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 30611) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |