| NPI | 1407246341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMEN DHYLLON Member 213-631-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS038245) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |