| NPI | 1306398037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD PHILIP BRILLIANT President 760-789-2882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59733) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |