NPI | 1538662036 |
---|---|
Entity Type | Organization |
Authorized Contact | MILES MADISON Owner 310-553-2940 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 37446) |
Enumeration Date | 2018-03-12 |
Last Update Date | 2024-05-21 |