| NPI | 1902148927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERCY MILLS Manager 310-672-7822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 29015) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |