| NPI | 1013978477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL DEROSIER Dr Owner 619-222-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 35869) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 35869) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2008-05-05 |