| NPI | 1174970461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAEID MALBOUBI Periodontist 949-200-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 52426) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-06-21 |