NPI | 1669833810 |
---|---|
Doing Business As | SB LIFETIME DENTAL |
Entity Type | Organization |
Authorized Contact | AZADEH MARY AFZALI President 909-881-3336 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55014) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 64657) |
Enumeration Date | 2016-03-16 |
Last Update Date | 2016-03-16 |