| NPI | 1699842492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHASHAYAR ETEMADI President 909-899-8757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-10-13 |