NPI | 1366014375 |
---|---|
Entity Type | Organization |
Authorized Contact | CHIEU PHAM Owner 619-421-5437 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2021-07-11 |
Last Update Date | 2021-07-11 |