| NPI | 1578576914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WARREN MALONE President/Surgeon 661-945-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 25591) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-22 |