NPI | 1508572439 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL H PARK Owner/President 310-901-2300 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2023-01-24 |
Last Update Date | 2023-01-24 |