| NPI | 1477044345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN C.A. LEE Dds 626-458-3410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 48688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 48595) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-05-25 |