| NPI | 1861139719 |
|---|---|
| Former Legal Business Name | EBI NIKJOO DENTAL CORP |
| Former Legal Business Name | NIKJOO DDS INC |
| Entity Type | Organization |
| Authorized Contact | EBI NIKJOO Owner 909-820-5062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |