| NPI | 1558812420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HISHAM ALKHATHEEB Owner 714-000-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 41699) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2017-04-19 |