| NPI | 1063138311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHAREH RABII President 310-938-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |