| NPI | 1952816118 |
|---|---|
| Doing Business As | COLLEGE GROVE DENTISTRY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ALI HEJAZI Dds/Owner 619-363-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2022-05-11 |