| NPI | 1811138639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIGORY ROZENOVICH Partner 714-549-1409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 40115) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 55624) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2009-03-09 |