| NPI | 1376803254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN JANE O'KEEFE Administrator 858-292-5175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2012-05-24 |