| NPI | 1235315433 |
|---|---|
| Doing Business As | MESA DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MAHA I HETATA Owner 949-646-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 40830) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 41699) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |