| NPI | 1952770455 |
|---|---|
| Doing Business As | 17TH STREET DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | KAREN J CAMP Manager 661-631-0529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 43593) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |