| NPI | 1013106335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PAUL Owner 818-667-6265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 33289) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2021-02-12 |