| NPI | 1629543228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMAD A YAZDI Member 310-401-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |