| NPI | 1992946206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MATIAN President / Dentist 818-345-5556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 57773) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2013-04-24 |