| NPI | 1083421960 |
|---|---|
| Doing Business As | MID WILSHIRE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | HOMAN HANASAB Owner 310-892-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2024-12-14 |
| Last Update Date | 2024-12-14 |