| NPI | 1154644193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN L. KREIZENBECK President 760-779-9989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2010-03-04 |