| NPI | 1336570993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE GOLDWYN JEQUINTO President 310-530-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 59173) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |