NPI | 1619287638 |
---|---|
Doing Business As | CCI HEALTH SERVICES |
Entity Type | Organization |
Authorized Contact | PARASTOO GOLESTANI Chief Dental Officer 301-340-7525 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14217) |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2010-10-08 |
Last Update Date | 2024-10-23 |