| NPI | 1578774550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH A. NICASSIO Owner 562-868-7768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA B33642) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |