| NPI | 1245437649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACQUEL A. MACASAET Dentist 818-881-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 52083) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-08-22 |