| NPI | 1891400453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L DIXON Owner 310-672-9623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-02-22 |