| NPI | 1447912761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA DOS SANTOS Manager 619-204-8082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-13 |