| NPI | 1447470844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIS CHARLES WONG President 323-464-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 29004) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |