| NPI | 1477723591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANSUREH S IRAVANI Owner 701-221-2719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ND 1928) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2014-04-14 |