| NPI | 1104202662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE LEIGH WALRATH Dentist 626-321-2334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 286500000X Military Hospital (Licence: SC DGD,8626.GD) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2015-08-07 |