| NPI | 1083874424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICELLE R ORTIZ-LUIS President 760-434-3119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47653) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2016-06-08 |