| NPI | 1851661169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MARTINEZ Office Manager / Secretary 818-855-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 61124) |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-02-24 |