| NPI | 1396260972 |
|---|---|
| Doing Business As | EL SEGUNDO MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | OMID R BARKHORDAR Owner 424-277-1138 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |