| NPI | 1225587876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM S MARKZAR Sole Owner 310-360-7570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2024-03-25 |