| NPI | 1376933622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY TURNER Chief Executive Officer 310-943-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 122300000X Dentist | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2025-03-24 |