| 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 |