NPI | 1366924912 |
---|---|
Entity Type | Organization |
Authorized Contact | BOBAK SHEMIRANI Owner 510-793-9025 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 47561) |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2018-08-30 |
Last Update Date | 2018-08-30 |