| NPI | 1912300427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN GABRIEL REYES President 323-728-5786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 46945) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |