| NPI | 1588095780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA SUZANNE FEIST Partner 310-453-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53211) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 56179) |
| 122300000X Dentist (Licence: CA 23635) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |