| 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 |