| NPI | 1134338833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI HEIDARI Owner 831-688-6531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43644) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 46264) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |