| NPI | 1699041798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO E TAI President 818-885-8650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 53735) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |