| NPI | 1407360522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANA SARAVIA-NELSON Manager 310-670-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 29557) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 44400) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 27953) | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |