| NPI | 1235754334 |
|---|---|
| Doing Business As | GLENDORA ORAL SURGERY AND IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | SUSAN JEAN LEE President 818-939-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |