| NPI | 1083350581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZAN SABAGH President 310-493-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain |
| Enumeration Date | 2022-05-08 |
| Last Update Date | 2022-06-14 |