| NPI | 1750582250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXIMILIAN CHANG Chief Executive Officer 310-378-5358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 46249) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |