| NPI | 1497980874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON ROBERT PECK Owner 310-657-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-06-10 |