| NPI | 1780900480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SHAPIRO Owner/ Operator 805-929-6814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 57466) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 57466) |
| 1223G0001X Dentist, General Practice (Licence: CA 57466) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 57466) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 57466) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 57466) | |
| 1223P0700X Dentist, Prosthodontics (Licence: CA 57466) | |
| 171100000X Acupuncturist (Licence: CA 57466) | |
| 208VP0000X | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: CA 57466) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2011-09-26 |