| NPI | 1003644667 |
|---|---|
| Doing Business As | SAN DIEGO DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JUSTENE DOAN Managing Dentist 619-265-6877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-07-24 |