NPI | 1174287668 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA H ARCHIE Owner Dentist 310-534-2633 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2021-10-29 |
Last Update Date | 2021-10-29 |