| NPI | 1063963668 |
|---|---|
| Doing Business As | MIGUEL MASTACHE DDS |
| Entity Type | Organization |
| Authorized Contact | MIGUEL ANGEL MASTACHE GUEVARA Dentist 664-685-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ZZ 6493848) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |