| NPI | 1376088955 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LESLIE S STROMMER Owner/Dentist 619-993-5078  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: CA 39334)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: CA 39339)  | 
| Enumeration Date | 2017-01-05 | 
| Last Update Date | 2017-01-05 |