| NPI | 1124686233 |
|---|---|
| Doing Business As | MY LA MIRADA DENTIST |
| Entity Type | Organization |
| Authorized Contact | RAMTIN KHAEF Owner 949-510-0225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-11 |