| NPI | 1013217579 |
|---|---|
| Doing Business As | RODEO DENTAL |
| Entity Type | Organization |
| Authorized Contact | RAFFY KOUYOUMDJIAN Owner 818-653-9799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 23066) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 21527) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2010-10-29 |