| NPI | 1962839795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER I GERBAKHER President 818-761-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 44175) |
| Enumeration Date | 2013-10-12 |
| Last Update Date | 2013-10-12 |