| NPI | 1720478597 |
|---|---|
| Doing Business As | LA TIJERA DENTAL PROFESSIONALS |
| Entity Type | Organization |
| Authorized Contact | MARSHA MOUTON Owner 310-256-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40688) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |