| NPI | 1982037420 |
|---|---|
| Other Name | TOLUCA LAKE COSMETIC DENTSITY |
| Entity Type | Organization |
| Authorized Contact | FARNOOSH TABESH President 443-928-8336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 57822) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |