| NPI | 1245681055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS REAL President/Dentist 619-425-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 52460) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |