| NPI | 1275781932 |
|---|---|
| Doing Business As | WILSHIRE PARK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | LEE JAY HARRIS Corporate Sec./ Exec. Director 213-380-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |