| NPI | 1457906869 |
|---|---|
| Doing Business As | ENCINO PRODENTAL |
| Entity Type | Organization |
| Authorized Contact | JEREMIAH BEISEL President 818-788-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-08-03 |
| Last Update Date | 2019-08-03 |