| NPI | 1326923939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN GRAHAM Chief Operating Officer 310-739-5685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |