NPI | 1710332838 |
---|---|
Former Legal Business Name | MODERN SMILES |
Entity Type | Organization |
Authorized Contact | KASRA TAJIK Dentist 818-763-9395 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 63665) |
Enumeration Date | 2016-04-26 |
Last Update Date | 2016-04-26 |