| NPI | 1164123519 |
|---|---|
| Doing Business As | KIDS 2 DENTIST DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JERRY LEE LANIER President 323-461-9942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |