| NPI | 1871075796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAIF R WADI Owner 210-861-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2022-09-14 |