| NPI | 1841051182 |
|---|---|
| Former Legal Business Name | FARAZ EDALATPAJOUH DENTAL INC |
| Entity Type | Organization |
| Authorized Contact | FARAZ EDALATPAJOUH Owner 310-529-5685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |