| NPI | 1366877953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP G MENNA Dentist 619-220-7000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 21613) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |