| NPI | 1013158617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHRNOOSH MONTAZERI President 323-888-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51111) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 49549) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2021-11-03 |