| NPI | 1902423494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY BOLDEN HOOKS President 323-896-7133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |