| NPI | 1154820686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BRENT DORSEY Owner 213-500-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 37976) |
| Enumeration Date | 2018-02-10 |
| Last Update Date | 2021-12-09 |