| NPI | 1306988118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAFOURA MASSOUMI Owner 619-425-9930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 40677) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2015-05-15 |