| NPI | 1801872395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN EBNER Owner 626-796-9246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA D37328) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-10-25 |