| NPI | 1659770618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAK KOHANOFF Dentist 818-343-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37850) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |