| NPI | 1851686562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR YAHIR MENDIETA Orthodontist 310-592-2057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30.022430) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-06-10 |