| NPI | 1104395326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MAHBOD RASHIDI President 949-770-8011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |