| NPI | 1215128988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHR FAIRUKE ELDER President 415-892-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA d46586) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2016-08-10 |