| NPI | 1912487372 |
|---|---|
| Doing Business As | BEVERLY GROVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DONNA LIEU CEO 323-933-9349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |