| NPI | 1982738639 |
|---|---|
| Other Name | AEGD |
| Entity Type | Organization |
| Authorized Contact | JEFFREY MICHAEL GOLDSTEIN Clinic Director 310-794-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA D46182) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |