| NPI | 1023337474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE Dentist 760-602-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44731) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 44373) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |