| NPI | 1629363494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYANT I BHATT Owner 909-464-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |