| NPI | 1649815697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARSHID ARIZ Owner 818-452-5325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-11-03 |