NPI | 1790034700 |
---|---|
Doing Business As | HIGH SIERRA DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | SALEEM M KIWAN Provider/Owner/President 559-224-3110 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 50411) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 50411) |
Enumeration Date | 2012-09-05 |
Last Update Date | 2012-09-27 |