| NPI | 1396250353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED CHAN Doctor 562-595-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44153) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 46396) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2017-12-12 |