| NPI | 1407597958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATIYA BAHMANYAR Owner 714-900-3340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2022-09-22 |