| NPI | 1336542851 |
|---|---|
| Doing Business As | CHILDREN'S DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JERRY DAVID MINSKY President 323-564-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 31668) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 24464) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 31668) | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2015-11-25 |