| NPI | 1003368135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD PHILIP BRILLIANT President 760-743-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59733) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |