| NPI | 1548782923 |
|---|---|
| Other Name | BLUE MOUNTAIN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MORTEZA KHATIBZAD Dentist 858-617-9051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 55489) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-07-07 |