| NPI | 1417070806 |
|---|---|
| Other Name | HOLLYWOOD BRACES |
| Entity Type | Organization |
| Authorized Contact | YURY B. GEYLIKMAN CEO 323-656-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 41255) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 41255) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2016-02-09 |