| NPI | 1356808711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE M LEE Owner 213-382-4336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2021-09-07 |