| Organization Name: | IWAMOTO ENTERPRISES, INC. |
| NPI Number: | 1023408580 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC TAKEO IWAMOTO (CEO/PRESIDENT) |
| Mailing Address: | 5451 Laurel Canyon Blvd Suite 202 Valley Village |
| State: | CA US |
| Postal Code: | 916072180 |
| Phone Number: | 8185066861 |
| Fax Number: | 8185063643 |
| NPI Enumeration Date: | 02/04/2015 |
| NPI Last Update Date: | 02/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 292200000X |
| License Number: | FAC00046448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Dental Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A commercial laboratory specializing in the construction of dental appliances that conform to a dentist |