NPI | 1356518310 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY R CROCKETT Owner 562-430-2740 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 20092) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 50687) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2008-05-09 |