| NPI | 1649597170 |
|---|---|
| Doing Business As | PORTER RANCH DENTAL STUDIO |
| Entity Type | Organization |
| Authorized Contact | BANG TAI PHAN President 818-368-8522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 46927) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |