| NPI | 1386747913 |
|---|---|
| Doing Business As | TIERRA TOWN DENTAL |
| Entity Type | Organization |
| Authorized Contact | NICOLE REID Regional Manager 619-261-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 31040) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |