| NPI | 1295946424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA MADANY President 949-951-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 54562) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 53924) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2020-08-22 |