| NPI | 1013401082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SHOUHED Orthodontist 310-666-6011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 65364) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |