| NPI | 1063873388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAY CAMACHO Office Manager 858-455-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 46565) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 33593) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 47565) | |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |