NPI | 1003109612 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN RICHARD WOLFSON Owner 818-998-6446 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA D27858) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA D28675) |
Enumeration Date | 2011-05-16 |
Last Update Date | 2011-05-16 |