| NPI | 1194227496 |
|---|---|
| Former Legal Business Name | FERNANDO DOMINGUEZ |
| Entity Type | Organization |
| Authorized Contact | FERNANDO DOMINGUEZ Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |