| NPI | 1376066977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICELA VIZCARRA Office Manager 858-679-2838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 40949) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |