| NPI | 1043660004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEVETLANA SHAHNAZARIANS Owner/Dentist 626-765-9758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 57036) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2017-11-21 |