| NPI | 1346061793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVID SEGURA Dental Assistant 310-670-1411 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-11-13 |