| NPI | 1295047066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIACHESLAV ZOUBTSOV President 626-201-6278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 48574) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |