| NPI | 1427424654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD LEW Chief Dentist 213-808-1790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 960000220) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2022-02-09 |