| NPI | 1871091645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIR SHAH Owner 909-746-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CA 53272) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |