| NPI | 1336875111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYANT I BHATT President 909-896-2957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2022-07-25 |