| NPI | 1952791816 |
|---|---|
| Doing Business As | FALLBROOK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KEVIN GHIANI CEO 310-486-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 00022G1335-001-2) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-02-18 |