| NPI | 1356406102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRMINA BAUTISTA MARTINEZ Dentist 760-439-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38085) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2009-12-14 |