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 |