| NPI | 1598038630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN VIVIANA DIAZ Owner 310-384-8398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ZZ 4660409) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |