| NPI | 1477952430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC OSMOLINSKI Owner 858-454-8485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 63159) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 56739) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |