| NPI | 1134329170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA IDALIA NORIEGA Office Meneger 626-966-4514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 46201) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2020-08-22 |