| NPI | 1578961504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED MOSTAFA MAHMOUD Dds 209-204-0754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52888) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |