| NPI | 1073028718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIANA CO TING KEH VILLAGO President 818-988-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 48054) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2017-12-04 |