| NPI | 1841566502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY F DEBORA Dentist 626-757-0490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48595) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 48688) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |