| NPI | 1487745089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A FREED Office Manager 310-553-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 18694) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |