NPI | 1386285427 |
---|---|
Doing Business As | BRENTWOOD MODERN DENTISTRY DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | SHAELAN D MCDONOUGH Owner 310-219-6039 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-09-30 |
Last Update Date | 2022-03-08 |