| NPI | 1316580806 |
|---|---|
| Doing Business As | CHILDRENS DENTAL FUNZONE |
| Entity Type | Organization |
| Authorized Contact | FARIBORZ RODEF President 626-412-0200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |