| NPI | 1982022745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUSSAM M GHARRAPH Owner/Director 909-709-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 29173) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2014-03-30 |