| NPI | 1861882862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN DAVAIE MOTLAGH President/Owner 949-307-9144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2013041566) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |