| NPI | 1013417443 |
|---|---|
| Doing Business As | FIRST STREET DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MAHIN G FARZIN CEO 714-546-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 43754) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 52980) |
| 1223P0700X Dentist, Prosthodontics (Licence: CA 49050) | |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |