| 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 |