| NPI | 1497955363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILI MIRTORABI Supervisor 323-589-3438 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2022-07-21 |