NPI | 1275950818 |
---|---|
Doing Business As | AV DENTAL GROUP |
Doing Business As | ANTELOPE VALLEY DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | DAVID S PARK Owner 310-403-1117 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 53724) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-03-20 |
Last Update Date | 2022-07-27 |