NPI | 1093252470 |
---|---|
Entity Type | Organization |
Authorized Contact | DAWNELLE PARK Owner/Dentist 310-303-3860 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 124Q00000X Dental Hygienist |
126800000X Dental Assistant | |
Enumeration Date | 2017-01-24 |
Last Update Date | 2017-01-24 |