| NPI | 1679742365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET ELIZABETH WONG President 310-390-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 49025) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 52131) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-06-17 |