| NPI | 1518420215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE FARZAM CEO 310-968-1866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |