| NPI | 1487463196 |
|---|---|
| Doing Business As | EASTLAKE VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | SITAL ANAND SHAH President 562-569-5808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-01-07 |