| NPI | 1184634693 |
|---|---|
| Other Name | DE SOTO DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | FARAMARZ EDALATPAJOUH President 818-888-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40811) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 41739) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |