| NPI | 1497914154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGE A PRESCOTT Dentist 626-337-7271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 35537) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 14915) |
| 124Q00000X Dental Hygienist (Licence: CA RDH16115) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 25306) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2009-08-18 |