NPI | 1689025538 |
---|---|
Entity Type | Organization |
Authorized Contact | FAREL ROSENBERG Owner 310-644-4412 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 17997) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2016-06-22 |