| NPI | 1861638132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD F STAFFORD Owner 323-856-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 27491) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2015-12-28 |