| NPI | 1770965055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW KEVIN ADDY Dentist/President 213-925-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 64006) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |