| NPI | 1053767137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA KIRKLAND Dental Hygienist Alte RN Ative Practi 310-733-7735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist |
| Additional Taxonomies | 125J00000X Dental Therapist |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-09 |