| NPI | 1952833998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY RANDOLPH SANNER Dentist Orthodontist 562-925-3765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 30470) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |