| NPI | 1649447236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFFY KOUYOUMDJIAN CEO 818-653-9799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23066) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 23066) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |