| 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 |