| NPI | 1457472615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ CONSUELO CUBILLOS Owener 818-888-7962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39040) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2016-08-12 |