| NPI | 1356868566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DHAVAL M SHAH Owner 909-864-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CA 47176) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-07-21 |