| 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 |