| NPI | 1316117104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VINCENT LAUREOLA President 310-792-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 55121) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2023-06-08 |