| NPI | 1962912139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FOON Dentist 626-795-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 51065) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 51065) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-06-16 |