| 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 |