| NPI | 1528789161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAK JAVIDI Owner Dentist 857-230-8493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-09-12 |