| NPI | 1851790661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CHANG President/Owner 310-264-1711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 53057) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 59653) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |