| NPI | 1992226104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ESMAILZADEH KHURASANY Owner 949-614-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 64760) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-06-28 |