| NPI | 1255615522 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | ARTHUR JOHNSON Owner 626-331-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA OMS36) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 54047) |
| 1223G0001X Dentist, General Practice (Licence: CA 55948) | |
| 1223G0001X Dentist, General Practice (Licence: CA 54322) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 47476) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 24358) | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |