| NPI | 1104988088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMEED BUTRUS TOMA Associate Dentist Partner 619-285-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 48043) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |