| NPI | 1275912891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT HALE Owner 818-999-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA D29601) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2016-06-07 |