| NPI | 1467840892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY PHILIP ALLEN CEO 760-593-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 56992) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |