| NPI | 1376635763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD CARVER MCCLENDON President Owner 323-298-0109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA Z6478) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2011-04-05 |