NPI | 1366684672 |
---|---|
Entity Type | Organization |
Authorized Contact | EVANGELOS ROSSOPOULOS Secretary 626-854-9530 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 31027) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 36605) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2012-01-05 |