| NPI | 1194925636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR JESUS FERNANDEZ President 562-806-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 53449) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |