| NPI | 1992064919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHIAS KAISAR JABBOUR President 909-800-2539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 23094) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |