| NPI | 1063631109 |
|---|---|
| Doing Business As | BAY AREA DENTAL SPECIALTY GROUP |
| Entity Type | Organization |
| Authorized Contact | FARSHAD MOFTAKHAR Owner CEO 626-246-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2008-07-15 |