| NPI | 1457033813 |
|---|---|
| Doing Business As | SAN YSIDRO HEALTH SENIOR DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | KEVIN MATTSON President/CEO 619-662-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-10-06 |