| NPI | 1487059010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOKVY NGONG Office Manager 562-494-5060 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40652) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA 40652) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |