| NPI | 1134329030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEJAS MODI President 951-657-1203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA D 47131) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA D36129) |
| 122300000X Dentist (Licence: CA D43182) | |
| 122300000X Dentist (Licence: CA D54136) | |
| 122300000X Dentist (Licence: CA D50823) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2018-08-22 |