| NPI | 1013190172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARVATHI KOKA POKALA Owner 858-274-0722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 40296) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |