| NPI | 1811011455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS JOHN BRAJEVICH Pediatric Dentist 310-378-1283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 41064) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-10-30 |