| NPI | 1063784825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NENI DIAH SHRIVER Owner 858-456-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 45194) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2014-02-21 |