| NPI | 1639120041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH A FOROOSH Owner 760-241-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 1223E0200X Dentist Endodontics | |
| 1223P0300X Dentist Periodontics | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-08-22 |