| 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 |