| NPI | 1184882391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRASNODARA N GASHPAROVA President 818-572-6375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 53452) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2008-05-26 |