| NPI | 1417152661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KADAM SHODHAN President 818-705-6565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 30295) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 30295) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |