NPI | 1104987445 |
---|---|
Doing Business As | MAGNOLIA GENTLE DENTISTRY |
Entity Type | Organization |
Authorized Contact | BENITA EVAZYAN Dentist 818-506-0100 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 43949) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 47472) |
Enumeration Date | 2006-12-12 |
Last Update Date | 2012-09-04 |