| NPI | 1952648354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS SCOTT ST. GEORGE Owner/President 562-927-2602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 57614) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |