| NPI | 1881711281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARISE R UNTALAN VP 213-385-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49693) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 49984) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |