| NPI | 1528451903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA LAURA FATHI Dentist 805-496-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 46336) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-10 |