| NPI | 1932650322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYVON JAVID Owner 310-325-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 48617) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2022-07-01 |