| NPI | 1265624399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIRAWAN SRIVIVATANAKUL Dentist 562-402-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 48771) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |