| NPI | 1821533183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR PEREZ Dds 818-261-2514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 00202682) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00202682) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |