| NPI | 1356174999 |
|---|---|
| Doing Business As | LA MESA FAMILY DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | RICARDO ROMAN Chief Financial Officer 619-906-4603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |