NPI | 1871631622 |
---|---|
Doing Business As | DBA CRENSHAW PROFESSIONAL DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | JEANINE T BLACK Business Administrator 323-731-0801 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 17880) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2017-04-11 |