| NPI | 1497130249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE S MEDELLIN Office Manager 818-280-5596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 56535) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |