| NPI | 1689982050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE AGAPITO TIU FAJARDO President/Dentist 626-582-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 56587) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2010-09-20 |