| NPI | 1528805553 |
|---|---|
| Doing Business As | PROACTIVE DENTAL CLINIC CORP |
| Entity Type | Organization |
| Authorized Contact | SOLAMAN SHIRE Administrator 310-883-8932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-09 |