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 |