The School-Aged Gap Elimination Initiative, INC
NPI #1689025843 in Indio, California
Provider Information
- NPI Number
- 1689025843
- Entity Type
- Organization
- Organization Name
- The School-Aged Gap Elimination Initiative, INC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jun 28, 2016
- Last Updated
- Sep 3, 2019
Practice Location
- Address
- 82900 AVENUE 42 STE B103
- City
- Indio
- State
- California
- ZIP Code
- 92203-9657
- Phone
- (760) 578-4748
Authorized Official
- Name
- DR. JAVAD SAGE AGHALOO, D.D.S
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (760) 578-4748
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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