| NPI | 1205370319 |
|---|---|
| Other Name | JONATHAN SHADI, DDS, INC |
| Entity Type | Organization |
| Authorized Contact | JONATHAN SHADI President 310-652-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 63560) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 58812) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-13 |