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 |