| NPI | 1972053361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA ZAK Dentist, CEO 310-706-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 38238) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 38238) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |