| NPI | 1336369768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ROBERT BACQUET C.E.O. 818-841-5654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 27725) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |