| NPI | 1275894297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIAVASH KEVIN BADII Director/Owner 909-798-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 54538) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |