| NPI | 1700083078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN MCKAY Office Manager 323-560-1508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA B26405-04) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-08-22 |