NPI | 1194122358 |
---|---|
Doing Business As | PRAIRIE FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | LUDIVINA LUIS PAGATPATAN President 310-303-3988 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 48162) |
Enumeration Date | 2014-12-03 |
Last Update Date | 2014-12-03 |