| NPI | 1871034397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMTIN NASSIRI President 925-298-5281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 54020) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 53997) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 55427) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 54020) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |