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 |