NPI | 1710002555 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD NICHOLAS ST. GEORGE President 562-927-2602 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 21404) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-08-22 |