| NPI | 1659903656 |
|---|---|
| Doing Business As | MAGICLAND DENTAL GROUP OF RANCHO DOMINGUEZ |
| Entity Type | Organization |
| Authorized Contact | MIGUEL REYES Q/A Contract & Compliance Manager 310-409-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2021-01-21 |