| NPI | 1487056180 |
|---|---|
| Doing Business As | KIDS' COMMUNITY DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | RICHARD MARIAS Board President, Volunteer Dentist 818-841-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DE33337) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 032653) |
| 124Q00000X Dental Hygienist (Licence: CA 27156) | |
| 124Q00000X Dental Hygienist (Licence: CA 27544) | |
| 126800000X Dental Assistant (Licence: CA 77534) | |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |