| NPI | 1275068025 |
|---|---|
| Doing Business As | LA PUENTE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | EDMOND TASH President 626-333-8166 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47422) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA 47422) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2018-06-20 |