NPI | 1811214356 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC THOMAS WONG President 310-259-2114 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 58395) |
Enumeration Date | 2010-04-23 |
Last Update Date | 2011-05-06 |