| NPI | 1093145237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK EDWIN STUART Provider/Owner 818-892-2649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 24875) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-11-26 |