| NPI | 1659041424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY K KEVORKIAN Orthodontist 818-763-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-14 |