| NPI | 1851705420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNAZ AHMADI Dentist, Owner 209-664-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51890) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-16 |