| NPI | 1235319898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOT K WATASE Dentist 323-724-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 42896) |
| Enumeration Date | 2007-11-11 |
| Last Update Date | 2013-11-12 |