| NPI | 1003299892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROYA NAZILA MIRKHAN President 858-337-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 44743) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 44743) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |