| NPI | 1124888144 |
|---|---|
| Doing Business As | PRIMARY TEETH PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | EVAN Y CHANG CEO 310-938-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |