| NPI | 1215054317 |
|---|---|
| Doing Business As | BROOKVALE FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | FARSHAD MOFTAKHAR Owner / CEO 626-246-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38565) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-07-15 |