| NPI | 1104088160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH KIANFU LEE Owner 818-344-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA SUR01353F) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2014-06-30 |