| NPI | 1417685041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY PASCUA Founder 760-436-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0001X Dentist, Dental Public Health | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2022-08-31 |