| NPI | 1043709538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VACHIK DANOUKH Doctor/President 818-787-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 56048) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |