| NPI | 1346849692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAROUIR DEIRMENJIAN Owner/CEO 310-497-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 122300000X Dentist | |
| 1223E0200X Dentist Endodontics | |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2021-02-24 |