| NPI | 1083056022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANE GRAHAM President 310-742-6088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 44404) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 44404) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2018-07-31 |