NPI | 1699177642 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY LEETRAKUL President 818-765-3534 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58017) |
Enumeration Date | 2014-09-22 |
Last Update Date | 2021-06-02 |