| NPI | 1063891851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HENNINGER CEO 760-940-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 57722) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2024-03-06 |