| NPI | 1114075314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PAUL VARBONCOEUR President 619-463-4486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 37512) |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2020-08-22 |