| NPI | 1154638500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYEDA SHABNAM HUQ Owner 760-775-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44484) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 56971) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |