| NPI | 1346406303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEL TODD BOUGHER President 619-708-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 47233) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |