| 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 |