| NPI | 1881417129 |
|---|---|
| Doing Business As | ENCINO SMILE MAKEOVER |
| Entity Type | Organization |
| Authorized Contact | PONEH GHASRI Dentist 818-990-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |