| NPI | 1316232432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE HERNANDEZ Office Manager 760-757-7720 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 56037) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-21 |