| NPI | 1093066169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D. KOSAKOSKI President 858-837-1128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN 10933) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |