| NPI | 1063083939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA TERESA CARRETTA Administrative Assistant 562-715-6135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2021-07-01 |