NPI | 1073794418 |
---|---|
Doing Business As | DENTALVILLE |
Entity Type | Organization |
Authorized Contact | MONIQUE R GOSMAN Cheif Of Staff 310-480-2307 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NV 3580) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2013-06-06 |