| NPI | 1922417138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHI MOSS Office Manager 310-640-0967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48276) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |