| NPI | 1154310472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZBETH CHAVEZ Office Manager 619-428-8682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38253) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2020-08-22 |