| NPI | 1407273139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYRA MARTINEZ Practice Manager 619-428-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55781) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-03-19 |