| NPI | 1861207771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHDOKHT YOUSEFIAN Provider 925-519-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-02-08 |
| Last Update Date | 2025-02-08 |