| NPI | 1952292005 |
|---|---|
| Doing Business As | PROVIDE DENTAL- CHESTERFIELD |
| Entity Type | Organization |
| Authorized Contact | PHILIP SON Owner/ General Dentist 323-787-9397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |