| NPI | 1275787210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH B MAK Owner/Dentist 626-793-6175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 11440191) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CA 11440191) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |