| NPI | 1457503922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SERRANO Administrator 619-270-2243 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ZZ MX15793) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |