| NPI | 1194089771 |
|---|---|
| Doing Business As | AGUA DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHAHROUZ AKHAVAN Dentist/Owner 818-968-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 25304) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |