NPI | 1194434670 |
---|---|
Former Legal Business Name | WOOLF DENTAL |
Entity Type | Organization |
Authorized Contact | KEVIN JOSEPH KOBLISKA Head Dentist 661-496-2175 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2022-11-23 |
Last Update Date | 2022-11-23 |