| NPI | 1467789719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIR KOROURI Secretary Of Corporation 310-927-5848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55323) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56649) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |