| NPI | 1730675661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADER EHSANI Owner 760-744-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 57053) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |