| NPI | 1417133158 |
|---|---|
| Former Legal Business Name | BELGRAVE FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAE H. SONG Owner 323-584-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 25630) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2016-03-21 |