| NPI | 1053552562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXEI I MIZIN President 818-225-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 54286) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2014-12-30 |