NPI | 1811055486 |
---|---|
Former Legal Business Name | BEVERLY HILLS DENTAL TRAUMA GROUP |
Entity Type | Organization |
Authorized Contact | JACOB F ESAGOFF President 310-858-1234 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 37656) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2013-08-19 |