| NPI | 1720498454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LAM Resident Dentist 626-808-6861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2014-05-02 |