| NPI | 1154773968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE KHALILI Dentist 310-926-0352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 41096) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |