| NPI | 1215360920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KEVIN BARRETT Owner 310-820-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-10-31 |