| NPI | 1528546801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA ADAMS Owner 310-216-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: CA 47212) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2019-11-20 |