| NPI | 1336513126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON MARK MONETTE President/Dentist 310-780-6266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40682) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 40682) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |