| NPI | 1033261391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED IHSAN KAYALI President 909-599-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 44495) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |