| NPI | 1487694840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M CERVANTES Owner 310-830-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 36051) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-08-25 |