| NPI | 1336445550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENN SOH Dentist/President/Owner 818-505-0106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 57033) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |