| NPI | 1356625537 |
|---|---|
| Doing Business As | AQUA DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHAHIN MAHALLATI Owner/President 714-640-2836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43194) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |