| NPI | 1972940252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYVAN BAMSHAD Dentist/Owner 818-345-6477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 46553) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2013-05-28 |