| NPI | 1710501846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY BRAGANZA Credentialing And Billing Manager 562-341-4786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |