| NPI | 1528287232 |
|---|---|
| Doing Business As | DENTALVILLE |
| Entity Type | Organization |
| Authorized Contact | MONIQUE R GLOSMAN Chief Of Staff 310-480-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 3580) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 3580) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2013-07-29 |