| NPI | 1710556550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN MARDIROSIAN Oral Surgeon 310-375-0514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-24 |