| NPI | 1457015943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA H ARCHIE Owner Dentist 562-630-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-10-29 |