NPI | 1053707265 |
---|---|
Former Legal Business Name | BEACH BRACES |
Entity Type | Organization |
Authorized Contact | PATRICIA PANUCCI Owner 310-379-0006 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 51124) |
Enumeration Date | 2015-04-14 |
Last Update Date | 2015-04-14 |