| NPI | 1417349143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER CHRISTIAN NISSLER Owner/Dentist 818-981-7375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 19789) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2016-06-15 |