| NPI | 1336675354 |
|---|---|
| Doing Business As | TOOTH SHOP |
| Entity Type | Organization |
| Authorized Contact | JEFF STEVEN BERLIN Partner 310-721-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 55277) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 47350) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |