| NPI | 1700273257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRNA LOPEZ Office Manager 818-786-3601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60105) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |