| NPI | 1497020119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORVARD ROUHANI Owner 626-795-6855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 43654) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 43654) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: CA 43654) | |
| 1223P0300X Dentist Periodontics (Licence: CA 43654) | |
| 1223P0700X Dentist Prosthodontics (Licence: CA 43654) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 43654) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 43654) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |