| NPI | 1629450598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURDES BUENO CAPULONG Dentist 323-257-7582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 40551) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-06-26 |