| NPI | 1215102124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIE CERVAS NATHANSON President 619-420-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 49158) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |