| NPI | 1659577088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIJAN AFAR Owner 310-855-2434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: CA 34457) |
| Additional Taxonomies | 122400000X Denturist (Licence: CA 38532) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |