| NPI | 1659850642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI MODARRES Dentist 714-692-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: CA 39186) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |