| NPI | 1295232031 |
|---|---|
| Former Legal Business Name | JOSE L SERVIN |
| Entity Type | Organization |
| Authorized Contact | JOSE L SERVIN Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ZZ 1004119) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |