| NPI | 1407058845 |
|---|---|
| Doing Business As | OTAY LAKES SMILES |
| Entity Type | Organization |
| Authorized Contact | GUADALUPE MARQUEZ President 619-934-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38716) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-08-16 |