| NPI | 1588284475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD SHIRAZ HAIDER Owner 949-472-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |