NPI | 1174037873 |
---|---|
Entity Type | Organization |
Authorized Contact | ROSA SALAZAR Administrator 310-644-4412 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 43750) |
Enumeration Date | 2017-11-17 |
Last Update Date | 2017-11-17 |