| NPI | 1760633341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHR FAIRUKE ELDER President / CEO 415-892-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 46586) |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2016-08-18 |