| NPI | 1568677243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILEE PETERSON CHAPPELL Office Manager 626-799-4187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 21419) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |