| NPI | 1528713534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIMA MASHHOON Dentist 805-934-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QE0002X Clinic/Center Emergency Care |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-03-10 |