| NPI | 1093980732 |
|---|---|
| Doing Business As | GRAND SMILES FAMILY AND COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JOSE EMMANUEL RUBIO DE LUNA Dentist/President 760-734-6829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47711) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 40781) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |