| NPI | 1508084799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARSHAD MOFTAKHAR Owner / CEO 626-246-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-07-15 |