| NPI | 1427104488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARTANTO LAWRENCE JUSTIN President 323-221-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39019) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |