| NPI | 1073024303 |
|---|---|
| Doing Business As | LAURA IVONNE RENDON D.D.S. |
| Entity Type | Organization |
| Authorized Contact | LAURA IVONNE RENDON Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ZZ 5229353) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: ZZ 7594023) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |