| NPI | 1073612388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA BANG Owner Dds 661-324-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 43355) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CA 43860) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 37440) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 49767) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |