| NPI | 1083965933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MCGARVEY Office Manager 760-243-3595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52059) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2015-07-20 |