| NPI | 1275837171 |
|---|---|
| Doing Business As | BOULEVARD DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY QUOC TIEN CEO 619-584-8975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57926) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |