| NPI | 1285357442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M BOGDON Owner Dentist 626-755-5245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |