| NPI | 1932533528 |
|---|---|
| Doing Business As | PICO VISTA DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOOWON KIM President 917-842-3225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54775) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54886) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2013-08-30 |