| NPI | 1629128145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH VELOSO President 310-973-1927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 261QD0000X) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |