| NPI | 1124134663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON MICHELE CROWDER Owner 818-706-8081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 30632) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |