| NPI | 1124388913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOSSEIN KIA EBRAHIM President/Dentist 949-350-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 36307) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 37778) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |