| NPI | 1902542541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAREH KOUYOUMDJIAN Owner 818-515-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-05-06 |