| NPI | 1043634124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLOMON POYOUROW Oral Surgeon/Co Owner 310-279-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 56129) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 55453) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 58092) | |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2014-02-18 |