| NPI | 1013345834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELY HASANY President 818-888-6860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 50605) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 55987) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |