| NPI | 1265180459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA I VALLESTEROS Owner Dentist 818-821-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-03-16 |