| NPI | 1053866517 |
|---|---|
| Doing Business As | HEAVENLY KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | ELSA WENDY HERNANDEZ Owner/President 619-251-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 56388) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |