| NPI | 1063632669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOUTAN HOSSEINI Dentist 661-324-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 41923) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2018-09-18 |