| NPI | 1134358427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SYCAMORE Dentist 213-709-7154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 053429) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2009-07-08 |