| NPI | 1184903825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN NEEDLE President 310-453-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 23856) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2012-07-03 |