| NPI | 1790406072 |
|---|---|
| Doing Business As | LA DENTAL BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | ALI KHAN CEO 424-273-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |