| NPI | 1376976985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD W MILLER Partner 626-796-5386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 21921) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 55124) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |