| NPI | 1588448500 |
|---|---|
| Doing Business As | MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MIGUEL REYES Q/A Contract And Compliance Manager 310-409-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2024-08-14 |