| NPI | 1851174627 |
|---|---|
| Doing Business As | GOLD COAST DENTAL DIAMOND BAR |
| Entity Type | Organization |
| Authorized Contact | ALAN BOVAL Chief Executive Officer 562-356-0948 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |