| NPI | 1982896072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN AMIR MASHHOON Owner/Dentist 408-360-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 38560) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CA 38560) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2016-03-08 |