| NPI | 1861179202 |
|---|---|
| Doing Business As | MAGICLAND CHILDREN'S DENTISTRY & ORTHODONTICS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MIGUEL REYES Q/A Contract & Compliance Manager 310-409-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-09-04 |