| NPI | 1114594538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATOOSA NIKAEEN Owner Dentist 818-225-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 1223P0221X Dentist Pediatric Dentistry | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2021-06-04 |