| NPI | 1205373388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HESSAM SIAVASH President 805-648-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 41811) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 59781) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |