| NPI | 1376714436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE MARIE LACKO Administrative Secretary/Insurance 562-698-0739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA DK026697) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |