| NPI | 1104010024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTO SEVILLA FLORES Dentist 626-332-8608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37822) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |