| NPI | 1386289478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATYA ARCHAMBAULT Owner 310-307-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |