| NPI | 1497366819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DURSCHLAG President 858-248-7005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |