| NPI | 1447455381 |
|---|---|
| Other Name | SCHOOL BASE PROGRAM |
| Entity Type | Organization |
| Authorized Contact | MARILUCI C BYRNES Director Of General Dentistry 619-234-8131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2025-09-02 |