| NPI | 1164472353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAN SU Owner Doctor 818-865-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 46977) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |