| NPI | 1356563084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENOUDA FATHY GEWAID Owner 909-982-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 49753) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-08-23 |