| NPI | 1427329952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS BOSQUE Owner/ President 858-999-5968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA 42723) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |