NPI | 1396949541 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY SIDERMAN President 323-585-1515 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2007-06-12 |
Last Update Date | 2007-08-10 |