| NPI | 1336964279 |
|---|---|
| Doing Business As | HACIENDA KIDZ DENTAL |
| Entity Type | Organization |
| Authorized Contact | AVESTA REDDY Dentist 323-898-4555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-11-16 |
| Last Update Date | 2024-11-16 |