| NPI | 1164585832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAN AYZIN Corporate Officer 818-240-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 34050) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 41813) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |