| NPI | 1548439284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANEESH BANSAL Administrator 323-263-6103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 39940) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |