| NPI | 1821494386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DOUGLAS GREENSTADT Owner 310-792-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 24300) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 24300) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-11-12 |