| NPI | 1780353516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALEED AHMAD Owner 415-349-1183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-03-16 |