| NPI | 1396044616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP G. MENNA Dentist 619-220-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 21613) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2011-03-25 |