NPI | 1982149522 |
---|---|
Entity Type | Organization |
Authorized Contact | HAMED GHORBANI-MOGHADDAM President 408-313-3228 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CT 11154) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 8514) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2017-01-05 |