| NPI | 1306187430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND YAKUBOV President 818-726-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57064) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-03-14 |