NPI | 1073782710 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIA CAMILA BORRERO FONSECA CEO 310-498-8167 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 51046) |
Enumeration Date | 2008-02-27 |
Last Update Date | 2019-01-22 |