| NPI | 1417228263 |
|---|---|
| Doing Business As | LAKEWOOD MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHRISTY HA THAI CEO 562-920-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47571) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-03-15 |