| NPI | 1881060838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSEL R JACINTO Owner/Dentist 818-240-6705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37841) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |