| NPI | 1588708309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARSHAD MOFTAKHAR Owner 310-274-7485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 29281) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |