NPI | 1093372351 |
---|---|
Doing Business As | ESCONDIDO PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | CHRISTIAN M FORTNEY CICCARELLA President 760-317-9598 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2019-05-22 |
Last Update Date | 2019-05-22 |