| NPI | 1508283227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK RUTHERFORD CEO 323-937-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 31174) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |