| NPI | 1245377795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS L DECKER President 619-543-1588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 29878) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 29977) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-06-12 |