| NPI | 1104581370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT WANG Doctor, Owner 626-796-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |