| NPI | 1114446747 |
|---|---|
| Doing Business As | BAY PARK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TESSA MILLER President 619-276-0963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-07-21 |