Organization
THE SCHOOL-AGED GAP ELIMINATION INITIATIVE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAVAD SAGE AGHALOO D.D.S (CHIEF EXECUTIVE OFFICER)
(760) 578-4748
Entity
Organization
Contact information
Practice address
82900 AVENUE 42 STE B103, INDIO, CA 92203-9657
(760) 578-4748
(760) 278-2172
Mailing address
82900 AVENUE 42 STE B103, INDIO, CA 92203-9657
(760) 578-4748
(760) 278-2172
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2016
Last updated
09/03/2019
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