| NPI | 1063236891 |
|---|---|
| Doing Business As | FAIROAKSSMILE |
| Entity Type | Organization |
| Authorized Contact | MAHMOUD MOHAMED Dentist 916-536-9410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |