| NPI | 1659653970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTRANIG GARY KELLEYAN Owner Dentist 626-960-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52409) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |