| NPI | 1366959009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JED D DE LA PAZ Owner Dentist 626-641-8214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 60772163) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |