| NPI | 1245424399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE MARIE BANIQUED QUIMSON General Dentist 310-538-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 39873) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2007-08-31 |