NPI | 1164641049 |
---|---|
Entity Type | Organization |
Authorized Contact | LARYSA SHULZHENKO President 818-890-9990 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 53649) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2011-09-14 |