| NPI | 1164810305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO MERCADO Owner/Officer 323-634-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59598) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2015-01-15 |