| NPI | 1457911992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALINA MAHGEREFTEH Owner 310-467-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |