| NPI | 1861125122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA HADDAD Owner 310-870-9652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |