| NPI | 1942382064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MICHAEL GOLDSTEIN Clinical Director 310-794-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA G01005) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-09-17 |