| NPI | 1497309306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA MALTEZ Office Manager 323-724-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-29 |