| NPI | 1629589759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE CHU President 626-775-5118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 64248) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 61087) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2022-06-02 |