| NPI | 1073763132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN V. TECSON Treatment Coordinator 323-257-4086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55264) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2008-09-25 |