| NPI | 1770601502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHIM ABDUL MUSTAFA Office Manager 909-364-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 42374) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2014-12-10 |