| NPI | 1689021255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY DALBY Office Supervisor 661-940-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 36862) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |