| NPI | 1780011189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER W CHANG Vice President 310-453-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 55758) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 55347) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |