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 |