| NPI | 1629580576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GIL GREENBURG President 818-205-1122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 30452) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 30452) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2017-11-01 |