| NPI | 1154491975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE DRAGO Owner 760-732-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47879) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 47072) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2014-11-07 |