| NPI | 1487994406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN CARSON Owner 818-889-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 48708) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2015-03-25 |