| NPI | 1790529287 |
|---|---|
| Former Legal Business Name | FAMILY AND COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | RANDA NASR General Dentist 909-831-2072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2024-06-20 |