| NPI | 1861685497 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS FLORES President 323-564-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA bf 33577) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |