| NPI | 1134201361 |
|---|---|
| Doing Business As | SOUTHWEST DENTAL |
| Entity Type | Organization |
| Authorized Contact | KENNETH R GALLION Dentist Owner President 760-770-0236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 39405) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |