| NPI | 1194521658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH L TONG Owner Dentist 323-251-0962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |