| 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 |