| NPI | 1104958172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M. JORDAN President 760-753-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 28169) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |