| NPI | 1790263465 |
|---|---|
| Doing Business As | WEST AV DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAVID PARK CEO 310-403-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53724) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2018-08-03 |