| NPI | 1912405119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLIE M MEMBRENO Front Office/Manager 626-332-7311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47170) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |