| NPI | 1912051418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FROOZ FATOORACHI-KORSAND President 760-732-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 41405) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-12-22 |