| NPI | 1962197897 |
|---|---|
| Doing Business As | MODERN DENTAL |
| Entity Type | Organization |
| Authorized Contact | BENNY KOHANTEB Dentist 818-631-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-04-06 |