| NPI | 1104346246 |
|---|---|
| Doing Business As | CHILDREN'S DENTAL BUILDING |
| Entity Type | Organization |
| Authorized Contact | MIGUEL REYES Q/A Contract & Compliance Manager 310-820-9933 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-06-27 |