| NPI | 1811196249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAD RADULOVICH Dentist/Owner 310-204-6661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 44531) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |